As the world’s leading expert on the treatment of idiopathic pruritus ani, I’m often asked if there is a simple homeopathic remedy that can be used to treat chronic anal itching. (I am not a medical doctor.The content here is simply a culmination of my experience communicating with literally thousands of anal itching sufferers over the past several years.)
When the anal itching affliction first hits, it’s natural to open the medicine cabinet and reach for any skin ointment that’s in there. That’s usually the beginning of what can be a terrible acceleration in the frequency and intensity of the need to scratch your bottom. When I use the word “bottom”, I’m referring to the entire anal and peri-anal region as well as the anus and the inner rim of the anus.Many people refer to this as rectal itching but the rectum is actually the mucous membrane at the end of the colon located about 2 inches (5 cm) inside the opening of the anus. Anal and rectal are NOT the same. The “anal skin” extends inward and connects with the rectum. The reason for this explanation is that I get a lot of questions from people asking if it’s ok to put ointment inside the anus. It’s very common to need to scratch just inside the anus. The answer to this question is yes, but just the inner rim.The mucous membrane of the rectum is very different from “anal skin” and reacts with ointment ingredients in dissimilar fashion. The FDA regulates drugs in the US and they differentiate drugs that can or cannot be used internally for that very reason. The FDA monograph (rules) for anal ointments and rectal drugs are different.If it says “external use only” on the label, that means “anal skin only”. Do not insert deep into the rectum. It’s okay to use on the inner rim of the anus as that is still anal skin.Suppositories and ointments with injection tubes are usually approved for the rectum.Inserting anything deep into the rectum that is not approved for rectal use is extremely unwise.
Typically, the most common ointments found in the home that first get used on an itchy anus is one made for hemorrhoids or a hydrocortisone anti itch ointment. Both usually end up making things worse (Cortisone ointments have additional side effects and residual effects and are not recommended for long term use.) At first, they feel good and you get relief.But eventually the itching becomes more and more frequent and the medicine no longer works for any extended period of time.I’ve come to believe that it’s the petrolatum in most ointments that when used for weeks at a time, creates a soggy environment in your anal region that leads to an expansion of the itching area from your anus to the entire peri-anal area. Any oil, natural or not, can lead to this over-moistured development which leads to more intense and more frequent itching.
In addition, the skin tissue is now more susceptible to tears and breaks while scratching. You then end up with open wounds that try to scab over to heal that creates even more itching. You now are probably waking up at night scratching away and creating more wounds and thus more scratching. Life becomes miserable. So you now try to counter the over moisturization by using powders and corn starch. I could go on and on, you get the point, the reason you’re here is because you likely have done all of the above.
So what can you do? What is the right thing to do for what now has become chronic, severe anal itching? The first thing to do is to understand what is causing the problem so you can deal with it. I go into detail about what causes anal itching in my blog.
Basically, the cause of chronic anal itching has no cure and it’s coming from your colon/rectum. This substance is causing the itching.You need to remove it and soothe the skin if removing it isn’t enough. You need to first heal your bottom and get the anal and perianal skin to the right moisture level, and then follow continue to clean and soothe whenever necessary to keep the itch away. That’s your home remedy! Every time the need to scratch or irritation develops, you simply go to the bathroom, clean your bottom with a non-medicated, cheap as you can buy, non-alcohol baby wipe. (Or they have adult wipes available now.) I get arguments from people telling me that baby wipes cause itching because of the preservatives or other ingredients in the wipe.Using water and wash cloth would be best they tell me. Worst thing you can do! Your bottom is itchy and you won’t be able to stop yourself from scratching with the wash cloth. For whatever reason, that cloth will end up doing a lot of damage down there and you won’t heal your bottom. It will forever stay in a state of being irritated at best, and oozing with wounds/skin damage at worst.
Using the input from thousands of anal itching sufferers, there is no question that baby wipes are the best way to clean your bottom without damaging the skin. Water sprayers and bidets do NOT clean well enough. The cause of the itching attaches itself or gets slightly absorbed and just does not wash off completely with water spraying alone. In addition, water pressure can push small amounts of water into the rectum that leaks out minutes or hours afterwards. This water leakage then leads to more itching.
You will likely feel like the urge to scratch increased while you cleaned. You clean until no color shows on the wipe. After you clean your bottom, it is imperative to pat it dry with toilet tissue. Do not rub or scratch with the toilet paper, pat your bottom dry. Hopefully the urge to scratch is now gone or greatly diminished. If not, it’s time to apply a zinc oxide based ointment (not petrolatum or oil based). Ask your pharmacist for a recommendation. Zinc oxide with minimal or zero petrolatum. Many diaper rash ointments qualify. Rub it in and lightly scratch without fingernails while applying the ointment and satisfy the itch. This is the only time you should scratch your bottom. It’s a lubricated scratch that will help prevent skin damage.
After years of research communicating with thousands of pruritus ani sufferers, the above is the absolute best home remedy for anal itching.This condition varies widely in intensity. In most cases it is a permanent life long problem that will have to be dealt with. For many, the above will work forever. For some, like me, zinc oxide just doesn’t provide much relief if any at all. A stronger anti-itch medication is necessary. The Pranicura Treatment has proven to work on 98+% of users who complete the 5 week healing process. There is no cure, but most sufferers only need to apply Pranicura once every few days or some can go weeks. Everyone follows the simple clean and pat dry process for life, while applying ointment only when necessary.